Assessment of Photodynamic Therapy As a Salvage Treatment for Local Failure After Chemoradiotherapy or Radiotherapy for Esophageal Cancer in Patients Aged 80 Years or Older

Overview

Journal DEN Open

Specialty Gastroenterology

Date 2022 Oct 3

PMID 36189170

Authors

Michiko Nishikawa

Yoshinobu Yamamoto

Saeko Kushida

Taku Hirabayashi

Syunta Tanaka

Naoki Takegawa

Takuya Mimura

Hidetaka Tsumura

Ikuya Miki

Masahiro Tsuda

Affiliations

Soon will be listed here.

Abstract

Objectives: Chemoradiotherapy (CRT) or radiotherapy (RT) alone is often the treatment of choice for elderly patients with esophageal cancer with the expectation of organ preservation. However, salvage treatment remains a problem when endoscopic resection is not indicated for local failure after CRT/RT. Photodynamic therapy (PDT) is indicated for local failure after CRT/RT, but there are few reports on its efficacy and safety in elderly patients. This study aimed to assess the outcome of PDT for local failure after CRT/RT for esophageal cancer in elderly patients.

Methods: This retrospective single-center study included 42 patients who first underwent PDT between April 2013 and June 2021. Patients aged ≥80 and <80 years were classified into the elderly and nonelderly groups, respectively. Local complete response rate, overall survival, progression-free survival, and incidence of adverse events related to PDT were compared retrospectively between the groups.

Results: The local complete response rate was 93.3% in the elderly group and 85.7 in the non-elderly group. The 2-year overall survival rate was 68.6% and 72.5%, and the 2-year progression-free survival rate was 49.5% and 70.0% in the elderly and nonelderly groups, respectively. There was no significant difference in any of these outcomes between the groups. In terms of adverse events, pneumonia and delirium tended to occur more frequently in the elderly group, but there were no serious adverse events in either group.

Conclusion: The outcome of salvage PDT in the local control was comparable between the elderly and nonelderly patients for local failure after CRT/RT for esophageal cancer.

Citing Articles

Predictive Factors for the Efficacy of Head and Neck Photoimmunotherapy and Optimization of Treatment Schedules.

Nishikawa D, Shimabukuro T, Suzuki H, Beppu S, Terada H, Kobayashi Y Cancer Diagn Progn. 2025; 5(2):179-188.

PMID: 40034957 PMC: 11871859. DOI: 10.21873/cdp.10428.

Novel Photodynamic Therapy for Esophageal Squamous Cell Carcinoma following Radiotherapy.

Yanagita T, Hikichi T, Nakamura J, Hashimoto M, Kato T, Suzuki R Life (Basel). 2023; 13(6).

PMID: 37374059 PMC: 10303686. DOI: 10.3390/life13061276.

The Prognostic Factors of Bloodstream Infection in Immunosuppressed Elderly Patients: A Retrospective, Single-center, Five-year Cohort Study.

Lin H, Gao Y, Qiu Y, Zhu H, Zhang S, Summah H Clin Interv Aging. 2022; 17:1647-1656.

PMID: 36425478 PMC: 9680683. DOI: 10.2147/CIA.S386922.

References

Amanuma Y, Horimatsu T, Ohashi S, Tamaoki M, Muto M . Association of local complete response with prognosis after salvage photodynamic therapy for esophageal squamous cell carcinoma. Dig Endosc. 2020; 33(3):355-363. DOI: 10.1111/den.13730. View

Herskovic A, Martz K, Al-Sarraf M, Leichman L, Brindle J, Vaitkevicius V . Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus. N Engl J Med. 1992; 326(24):1593-8. DOI: 10.1056/NEJM199206113262403. View

Hironaka S, Ohtsu A, Boku N, Muto M, Nagashima F, Saito H . Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T(2-3)N(any) M(0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2003; 57(2):425-33. DOI: 10.1016/s0360-3016(03)00585-6. View

Mantziari S, Farinha H, Bouygues V, Vignal J, Deswysen Y, Demartines N . Esophageal Cancer in Elderly Patients, Current Treatment Options and Outcomes; A Systematic Review and Pooled Analysis. Cancers (Basel). 2021; 13(9). PMC: 8123886. DOI: 10.3390/cancers13092104. View

Ishida N, Osawa S, Miyazu T, Kaneko M, Tamura S, Tani S . Photodynamic Therapy Using Talaporfin Sodium for Local Failure after Chemoradiotherapy or Radiotherapy for Esophageal Cancer: A Single Center Experience. J Clin Med. 2020; 9(5). PMC: 7290876. DOI: 10.3390/jcm9051509. View

Kitagawa Y, Uno T, Oyama T, Kato K, Kato H, Kawakubo H . Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus. 2018; 16(1):1-24. PMC: 6510883. DOI: 10.1007/s10388-018-0641-9. View

Toh Y, Numasaki H, Tachimori Y, Uno T, Jingu K, Nemoto K . Current status of radiotherapy for patients with thoracic esophageal cancer in Japan, based on the Comprehensive Registry of Esophageal Cancer in Japan from 2009 to 2011 by the Japan Esophageal Society. Esophagus. 2019; 17(1):25-32. DOI: 10.1007/s10388-019-00690-z. View

Yamashita H, Kadota T, Minamide T, Sunakawa H, Sato D, Takashima K . Efficacy and safety of second photodynamic therapy for local failure after salvage photodynamic therapy for esophageal cancer. Dig Endosc. 2021; 34(3):488-496. DOI: 10.1111/den.14072. View

Sekiguchi M, Oda I, Suzuki H, Abe S, Nonaka S, Yoshinaga S . Clinical outcomes and prognostic factors in gastric cancer patients aged ≥85 years undergoing endoscopic submucosal dissection. Gastrointest Endosc. 2016; 85(5):963-972. DOI: 10.1016/j.gie.2016.10.013. View

10.

Tamaoki M, Yokoyama A, Horimatsu T, Hirohashi K, Amanuma Y, Higuchi H . Repeated talaporfin sodium photodynamic therapy for esophageal cancer: safety and efficacy. Esophagus. 2021; 18(4):817-824. PMC: 8387249. DOI: 10.1007/s10388-021-00853-x. View

11.

Yano T, Kasai H, Horimatsu T, Yoshimura K, Teramukai S, Morita S . A multicenter phase II study of salvage photodynamic therapy using talaporfin sodium (ME2906) and a diode laser (PNL6405EPG) for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Oncotarget. 2017; 8(13):22135-22144. PMC: 5400653. DOI: 10.18632/oncotarget.14029. View

12.

Minamide T, Yoda Y, Hori K, Shinmura K, Oono Y, Ikematsu H . Advantages of salvage photodynamic therapy using talaporfin sodium for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Surg Endosc. 2019; 34(2):899-906. DOI: 10.1007/s00464-019-06846-3. View

13.

Han Y, Liu S, Guo W, Zhang Y, Li H . Clinical outcomes of oesophagectomy in elderly versus relatively younger patients: a meta-analysis. Interact Cardiovasc Thorac Surg. 2019; 29(6):897-905. DOI: 10.1093/icvts/ivz208. View

14.

Tachimori Y, Kanamori N, Uemura N, Hokamura N, Igaki H, Kato H . Salvage esophagectomy after high-dose chemoradiotherapy for esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg. 2009; 137(1):49-54. DOI: 10.1016/j.jtcvs.2008.05.016. View

15.

Yano T, Muto M, Minashi K, Onozawa M, Nihei K, Ishikura S . Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2011; 43(8):657-63. DOI: 10.1055/s-0030-1256373. View

16.

Jingu K, Numasaki H, Toh Y, Nemoto K, Uno T, Doki Y . Chemoradiotherapy and radiotherapy alone in patients with esophageal cancer aged 80 years or older based on the Comprehensive Registry of Esophageal Cancer in Japan. Esophagus. 2020; 17(3):223-229. DOI: 10.1007/s10388-020-00725-w. View

17.

Miyamoto Y, Nonaka S, Oda I, Abe S, Suzuki H, Yoshinaga S . Safety and usefulness of endoscopic submucosal dissection for early esophageal cancers in elderly patients aged 80 years or older. Esophagus. 2020; 18(1):81-89. DOI: 10.1007/s10388-020-00750-9. View

18.

Hayashi T, Asahina Y, Nakanishi H, Terashima T, Okamoto K, Yamada S . Evaluation of the efficacy and safety of salvage photodynamic therapy by talaporfin sodium for cervical esophageal cancers and lesions larger than 3 cm. Esophagus. 2020; 18(3):645-654. DOI: 10.1007/s10388-020-00799-6. View

19.

Hatogai K, Yano T, Kojima T, Onozawa M, Daiko H, Nomura S . Salvage photodynamic therapy for local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Gastrointest Endosc. 2015; 83(6):1130-1139.e3. DOI: 10.1016/j.gie.2015.11.016. View